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Parotitis is a rare but serious staphylococcal infection of the parotid gland which may cause post-operative fever. It is limited almost entirely to elderly, dehydrated, debilitated, and malnourished patients with poor oral hygiene. It appears in the second post-operative week and is associated with prolonged nasogastric intubation.
It results from decreased secretory activity with inspissation of parotid secretions that become infected with staphylococci or gram negative bacteria from the oral cavity. Cells accumulate in the medium and large-sized ducts eventually causing obstruction. There is inflammation, and eventually, abscess formation. The abscesses may spread to periglandular tissue so involving the auditory canal, superficial skin, and the neck. Failure to treat the disease at this stage may produce acute respiratory failure from tracheal obstruction.